Provide an Advance Care Planning (ACP) service that assures individual’s wishes for medical care are followed when they are unable to participate in the conversation.   Public concerns over an individual’s right to determine their own health care led to state legislative efforts to encourage the use of advance directives.  Similar federal efforts resulted in what is commonly referred to as the Patient Self Determination Act (PSDA), requires six types of Medicare and Medicaid funded providers—hospitals, nursing homes, hospices, home health agencies HHAs, health maintenance organizations, and Medicare Advantage MA organizations to maintain written policies and procedures to inform those they serve about advance directives, and document information about individuals’ advance directives in the medical record